COPE, a Model for Building Community Partnerships That Improve Care in East Africa

Dohlie, Maj-Britt; Mielke, Erin; Bwire, Theodora; Adriance, D; Mumba, Feddis

doi:10.1111/j.1945-1474.2000.tb00151.x

Cited by 7 publications

(3 citation statements)

References 9 publications

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“…Applying approaches (e.g., Client-Oriented, Provider-Efficient Services [COPE] and Partnership-Defined Quality) that bring community members and providers together to discuss their respective perceptions of high-quality care and to address the sources of pressure or motivation to increase labor or speed delivery through uterotonics [32], [33].…”

Section: Discussionmentioning

confidence: 99%

Knowledge, Attitudes, and Practices Related to Uterotonic Drugs during Childbirth in Karnataka, India: A Qualitative Research Study

et al. 2013

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Background and ObjectivesIndia has the highest annual number of maternal deaths of any country. As obstetric hemorrhage is the leading cause of maternal death in India, numerous efforts are under way to promote access to skilled attendance at birth and emergency obstetric care. Current initiatives also seek to increase access to active management of the third stage of labor for postpartum hemorrhage prevention, particularly through administration of an uterotonic after delivery. However, prior research suggests widespread inappropriate use of uterotonics at facilities and in communities–for example, without adequate monitoring or referral support for complications. This qualitative study aimed to document health providers’ and community members’ current knowledge, attitudes, and practices regarding uterotonic use during labor and delivery in India’s Karnataka state.Methods140 in-depth interviews were conducted from June to August 2011 in Bagalkot and Hassan districts with physicians, nurses, recently delivered women, mothers-in-law, traditional birth attendants (dais), unlicensed village doctors, and chemists (pharmacists).ResultsMany respondents reported use of uterotonics, particularly oxytocin, for labor augmentation in both facility-based and home-based deliveries. The study also identified contextual factors that promote inappropriate uterotonic use, including high value placed on pain during labor; perceived pressure to provide or receive uterotonics early in labor and delivery, perhaps leading to administration of uterotonics despite awareness of risks; and lack of consistent and correct knowledge regarding safe storage, dosing, and administration of oxytocin.ConclusionsThese findings have significant implications for public health programs in a context of widespread and potentially increasing availability of uterotonics. Among other responses, efforts are needed to improve communication between community members and providers regarding uterotonic use during labor and delivery and to target training and other interventions to address identified gaps in knowledge and ensure that providers and pharmacists have up-to-date information regarding proper usage of uterotonic drugs.

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Section: Discussionmentioning

confidence: 99%

Knowledge, Attitudes, and Practices Related to Uterotonic Drugs during Childbirth in Karnataka, India: A Qualitative Research Study

et al. 2013

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“…The EngenderHealth-developed COPE® cervical cancer quality improvement process uses a clients' rights and providers' needs framework and is a well-documented and well-established QI approach used at the primary health care level in many countries globally. [22][23][24][25] The COPE® process employs client surveys, health leader interviews, and the quarterly development of action plans for each health facility. The action planning process is managed by a quality improvement committee at each facility.…”

Section: Community-engaged Quality Improvementmentioning

confidence: 99%

Multi-site community-engaged quality improvement to inform regional cervical cancer screening implementation and sustainment in rural Sénégal

Jesus

Thiam

Sagna³

et al. 2020

Preprint

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Background The improvement of quality at the primary health care level in low resource settings is key to addressing health equity challenges around the world. In 2014, a Sénégal-Peace Corps-University of Illinois at Chicago partnership began to study the impact of a community-engaged quality improvement program on health services and regional health system determinants to prevent cervical cancer, the leading cause of cancer deaths among women in Sénégal. The purpose of this paper is to describe how a multi-site participatory quality improvement (QI) approach can identify access barriers and provide contextualized programmatic recommendations to strengthen the cervical cancer screening program in the rural Kédougou region of Sénégal and inform higher-level program implementation and sustainment. Methods : We adapted a facility-level quality improvement process by involving community health committee representatives. Using a mixed methods case study approach, we collected data at nine demonstration sites in the K é dougou region from quality improvement program action plans, client surveys, health leader interviews, and service guidelines discussions at the regional level from January 2015 through June 2019. We calculated the demand and supply-side barriers and organized them into the Levesque Patient-Centered Access to Health Care Framework. Results During the study period, 27 quality improvement meetings took place. There were a total of 50 (14 unique) stated access barriers to cervical cancer prevention across all sites. The health service barriers were concentrated in approachability (5) and availability and accommodation (16), whereas the demand-side barriers were concentrated in the ability to perceive (14) and ability to seek care (3). Individual health facilities responded with increased community outreach among other interventions while regional programmatic recommendations led to strategic partnership initiatives such as social mobilization and peer-to-peer education activities. Conclusions The community-engaged QI process has meaningfully contributed to strategic planning of the implementation and sustainment of a cervical cancer screening program within the context of rural Kédougou, Sénégal. The iterative and patient-focused nature of QI has allowed health personnel to continually strengthen how they deliver their health services to meet the community’s needs while data aggregated from QI action plans across multiple sites has helped inform responsive health policies to ensure program sustainment. The parallel and iterative application of participatory capacity building and QI activities across multiple sites provides a useful approach for implementing sustainable cervical cancer programs.

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“…EngenderHealth-sponsored needs assessments, jointly conducted by health facility staff and community members, have made clear that the latter have opinions about services and suggestions for their improvement, but that they are rarely asked to speak up and are rarely heard when they do. These needs assessments have also made clear that community members feel greater ownership of health services when they are asked their opinion about them, and that community meetings provide an opportunity for health care providers to increase the community's knowledge about specific issues, e.g., OFs [18].…”

Section: Why Does Community Engagement Matter?mentioning

confidence: 99%

Improving community knowledge of obstetric fistula prevention and treatment

Wegner

Ruminjo

Sinclair

et al. 2007

Intl J Gynecology & Obste

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In recent years, information has emerged in the scientific literature regarding the experience of physicians and clinical staff who try to prevent and treat obstetric fistulas at health facilities in developing countries. However, little is known about attempts to match the services they provide with policy and programmatic interventions in the communities they serve. To determine what is known about community involvement in the prevention and treatment of obstetric fistulas, the authors inquired into experiments carried out by EngenderHealth and partners in 15 African and Asian countries. From raw data, gray literature, and personal communications with those working in the field, they learned that engaging the community may be the keystone in the eradication of fistulas in low-resource settings, and they learned how to engage the community.

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COPE, a Model for Building Community Partnerships That Improve Care in East Africa

Cited by 7 publications

References 9 publications

Knowledge, Attitudes, and Practices Related to Uterotonic Drugs during Childbirth in Karnataka, India: A Qualitative Research Study

Knowledge, Attitudes, and Practices Related to Uterotonic Drugs during Childbirth in Karnataka, India: A Qualitative Research Study

Multi-site community-engaged quality improvement to inform regional cervical cancer screening implementation and sustainment in rural Sénégal

Improving community knowledge of obstetric fistula prevention and treatment

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